8 Scary Food-Drug Interactions

Pairing greens and grapefruit with certain medications might mean a trip to the ER. Here are some combos to watch for

Food Isn’t Harmless

En español |A whopping 81 percent of adults ages 57 through 85 take at least one prescription medication, according to research published in Gerontologist, and what you eat and drink can affect the way those medicines work. Don’t learn the hard way which foods can prevent a prescription orover-the-counter drug from working, or exacerbate its side effects. Instead, find out which pairings to avoid — as well as one particular combo that actually works well together.

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Buh-Bye, Bananas?

ACE inhibitors such as captopril (Capoten), enalapril (Vasotec) and lisinopril (Prinivil) can be your heart’s best friend because they relax blood vessels so blood flows more smoothly. They can also increase the amount of potassium in your body, and too much potassium can cause an irregular heartbeat or heart palpitations. If on an ACE inhibitor, avoid eating large amounts of potassium-rich foods such as bananas, oranges and salt substitutes that contain potassium.

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No Cheese, Please

Wine and beer pair perfectly with aged cheeses. Still, if you’re taking certain antidepressants — specifically, monoamine oxidase inhibitors (MAOIs) such as selegiline (Emsam)— you need to steer clear of all three. The reason: “Foods containing yeast as well as those that have been aged or fermented can cause blood pressure to spike,” says Bola Oyeyipo, a geriatrician based in San Antonio. “And that can increase the chance of stroke.”

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A Dairy Don’t

Having a glass of milk every day may be a do, but using it to wash down your multivitamin with iron or your antibiotic (including tetracyclines or fluoroquinolones) is a definite don’t. Here’s why: “When ingested together, the dairy binds to the medicine and forms what’s called a complex,” Oyeyipo explains. “It doesn’t harm you, but less of the vitamin or antibiotic is absorbed.” After taking your pill, wait two hours before drinking or eating dairy products.

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Bring on the D

Some anticonvulsants, such as phenytoin (Dilantin, Phenytek), are prescribed not only for epilepsy but also for patients who’ve had a brain injury such as a stroke. The problem is that these drugs limit the absorption of vitamin D and calcium — nutrients that are important to bone health and key to avoiding osteoporosis in both men and women. One solution: When on anticonvulsants, be sure to get 10 minutes of sunshine a day, take in adequate dairy, and consult a health care provider to see if you might need a supplement, says Burgin Ross, an assistant professor of nutrition at the University of North Carolina at Greensboro.

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Goodbye to Grapefruit?

A half grapefruit is a great way to start the day — unless you’re taking a cholesterol-lowering statin such as atorvastatin (Lipitor) or simvastatin (Zocor). “Patients should avoid grapefruit entirely when on statins because it increases the side effects of the medication,” Oyeyipo says. The most common side effect? Muscle aches. Interestingly, oranges and lemons are fine to eat with statins.

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Leafy Greens Alert

If you’re taking the blood thinner warfarin (Coumadin, Jantoven), you may want to regulate your consumption of dark, leafy greens. The clot-preventing drug allows blood to flow more easily by blocking the liver’s production of vitamin K, which is essential to clot formation. But green, leafy veggies such as collard greens, spinach and turnip greens are rich in vitamin K. They’re also healthy, so you shouldn’t avoid them altogether. Instead, eat them consistently — once or twice a week, every week.

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Acetaminophen + Alcohol = Trouble

If you suffer from muscle aches, headaches or arthritis, acetaminophen (Tylenol) is probably your go-to analgesic. However, it can cause liver damage, and the chance for severe damage is higher if you drink three or more alcoholic beverages a day. So go ahead and have wine with dinner, but follow the recork rule and put the bottle away after a glass or two to avoid further temptation.

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Fatty Foods? In This Case, Yes.

There’s an exception to every rule, and this one’s particularly delicious. When taking antifungal medications such as griseofulvin (Grifulvin V, Gris-PEG) to battle a skin fungal infection, go ahead and order the cheeseburger and the fries. “These drugs work best when taken with fatty foods,” Oyeyipo says. “I tell my patients to eat something really greasy — the drug’s absorbed better that way.”